<extend name="./Template/Admin/Base/base.tpl" />
<block name="body">
<div class="ch-container">
	<div class="row">

		<div class="row">
			<div class="col-md-12 center login-header">
				<h2>报名入驻</h2>
			</div>
			<!--/span-->
		</div>
		<!--/row-->

		<div class="row">
			<div class="well col-md-5 center login-box">
				<div class="alert alert-info">欢迎您的入驻，请填写您的相关信息</div>
				<form class="form-horizontal" action="__MODULE__/Index/enter" method="post">
					<fieldset>
						<div class="input-group input-group-lg">
							<span class="input-group-addon"><i
								class="glyphicon glyphicon-lock red"></i></span> <input
								type="text" class="form-control" placeholder="公司" name="company">
						</div>
						<div class="clearfix"></div>
						<br/>
						<div class="input-group input-group-lg">
							<span class="input-group-addon"><i
								class="glyphicon  glyphicon-home red"></i></span> <input
								type="text" class="form-control" placeholder="地址" name="address">
						</div>
						<div class="clearfix"></div>
						<br/>
						<div class="input-group input-group-lg">
							<span class="input-group-addon"><i
								class="glyphicon glyphicon-user red"></i></span> <input
								type="text" class="form-control" placeholder="姓名" name="name">
						</div>
						<div class="clearfix"></div>
						<br/>
						<div class="input-group input-group-lg">
							<span class="input-group-addon"><i
								class="glyphicon glyphicon-earphone red"></i></span> <input
								type="tel" class="form-control" placeholder="电话" name="phone">
						</div>
						<div class="clearfix"></div>
						<br/>

						<p class="center col-md-5">
							<button type="submit" class="btn btn-primary">提交</button>
						</p>
					</fieldset>
				</form>
			</div>
			<!--/span-->
		</div>
		<!--/row-->
	</div>
	<!--/fluid-row-->
</div>
<!--/.fluid-container--> 
</block>